1645 W PALAIS RD (3)oi\^n
Anaheim Union High School District RECEIVED
JUN 0 8 2022
UNLIMITED 501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
CITY OF ANAHEIM
PLANNING &BUILDING DEPARTMENTCERTIFICATEofCOMPLIANCE
PAYMENT of SCHOOL FACILITY FEES
NOTICE:The 90-day period in which you may protest the fee described herein will begin on the date this fee is paid.However,if the fee was
imposed by the City or County as a condition of approval for your project,and you have received the requisite notice,the 90-day protest period
began at the time your project was approved.Returned checks (NSF)are subject to a $30.00 administrative fee.
RECEIPT NO.:ELEMENTARY DISTRICT:HIGH SCHOOL DISTRICT:
Anaheim Union High School District1A
OWNER INFORMATION:
Phone Number;Home (1 Cell
Name:
Address:2
APPLICANT INFORMATION:
Name:3
T/t^Phone Number:Home (Cell
PROPERTY INFORMATION:
Project Address:t tv/^'pz4<A'^Development Type;{'/)Residential -New ()Residential -Room Addition
()Single Family ()Multi-Family Condos/Apartments #of units:
Project Name:M
4 ()Commercial;
7COMMERCIAL:
Total Square Footage;
Multiplied by Current Rate
RESIDENTIAL:43^^.^r,Total Square Footage:
Multiplied by Current Rate
Elem.$?.Oy :?/)3/.gyH.S.$C3>h ^
5 Elem.$=$
=$
Equals TotaLfcSTS =$Equals Total Fee:$=$_
FEE WAIVER:
Fees Waived:{)Yes6 No If yes,reason:
NOWLEDGEMENT^
Th^bove respresentations as to square footage are true,Developer/Appllcant agrees that if it is later determined that such respresentations
^f=e not true.Certificate shall automatically terminate aQd the appropriate City/County shall be notified.7
Developer/Applicant Signature:
CERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and
65995.
8
3J2
Represe^tive -Anaheim Union High School DistrictDate
ACTUAL FEES PAID:
^*7/o i-c>^D
S -<n3i ■
Check No.
Check No.
9
Anaheim Union H.S.DIst.
Distribution:Developer/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department